Maria Marshall, PhD, RP & Edward Marshall, MD, PhD, RP
October 29, 2025
Introduction:
Among the hundreds of psychotherapeutic approaches, there is perhaps none as versatile and flexible as Viktor E. Frankl’s Logotherapy and Existential Analysis (LTEA). This meaning-centered approach to psychotherapy has been described as “’…the last school whose teaching body has been developed in terms of a systematically organized structure’” (Torello, cited by Frankl, 2014:124).
In keeping with the evolution of the practice of psychotherapy, supervision in LTEA has to follow suit and respond with a well-developed and thought-through structure. The current challenge in the training of logotherapists and supervisors is (1) offering quality training programs that follow a unified, structured protocol with clearly defined goals and objectives that correspond to the development of therapists’ competence; (2) developing programs which incorporate current research findings and reflect an understanding of ethical issues and principles that govern clinical practice and decision making; and (3) offering a curriculum which follows guidelines of excellence in clinical practice while firmly rooted in Frankl’s original thought.
We need to bear in mind that supervisor training in the LTEA framework is an emerging field. Traditionally, supervision and consultation occurred at facilities where practitioners of medicine, psychology, psychotherapy, and psychiatry were trained, such as at the Polyclinic Hospital, or the University of Vienna Medical School. During his lectures at several American universities, Dr. Frankl’s work became known to a wider audience. Since its founding in 1986, the South German Institute of Logotherapy, headed by Dr. Frankl’s most prominent student, Dr. Elisabeth Lukas, became one of the first training institutes for logotherapists. Graduates of this program participated in a structured curriculum, the content and guidelines of which were published by The Elisabeth Lukas Archives in 2013 (Lukas, 2013). While this curriculum was adopted by therapists and leaders of logotherapy institutes, a large variety in the length, intensity, and duration of training programs offered in logotherapy and existential analysis remains.
Historical Overview:
At the time when Dr. Frankl completed his medical studies, psychotherapy, as a profession, was reserved for medical doctors. Students learned by observing the work of their mentors and conversing with them during and after their presentations and demonstrations.
A trend in therapist training, influenced by psychoanalysis, was to engage in one’s personal therapy to gain self-awareness and to have a first-hand experience with the processes and dynamics that may surface during the therapeutic process. Dr. Frankl’s main concerns with this approach were to avoid “navel gazing,” which is an excessive self-reflection and self-observation. He was looking for a method that would allow for reflection but correspond with the premise of logotherapy and existential analysis to look beyond the confines of the self and discover meaning. In response to his dilemma, Dr. Lukas developed a biographical method for self-experience for therapists which helped to review one’s life story along distinct but interconnected life stages and notice and discover meaning. This course became a mandatory component of education in logotherapy at her center, along with courses on mastering and leading logotherapeutic dialogues.
By the 1990s, regulations in Europe and Austria became more specific about the required number of supervision hours that psychotherapists needed to complete during their practicums. International students who studied with Dr. Lukas and with Dr. Frankl established institutes through which they provided training according to their counties’ requirements. Each institute was responsible for meeting the professional regulations and adhering to the ethical standards.
In2012, The International Association of Logotherapy and Existential Analysis, with its headquarters in Vienna, was formed “…to promote high excellence in the professional conduct of logotherapy training, practice, and research [as well as] the training of therapists in the use of logotherapy.” One of the aims of this association is to ensure that its members meet the minimum recommended standards for training in LTEA and align themselves with the APA code of ethics.
Experience with Dr. Frankl:
When asked about his legacy, Frankl stated that “…the meaning of [his] life was to help others find the meaning of theirs” (Frankl, 2000:129). He purported that logotherapy is what is in his books, “Reading are rereading my books spares [practitioners] reinventing logotherapy and thus saves time for their share in its further development” (Frankl, 2014:124). He has repeatedly emphasized that what he wanted was not parrots repeating what they heard from their masters, but creative and dynamic therapists, “…independent and inventive, innovative and creative spirits,” who are able to improvise and tailor treatment interventions according to the needs of the patients (Frankl, 2014:123).
In several of his books, Frankl made it clear, that a therapeutic intervention of choice, “Ψ,” depends on two variables, “Ψ = X + Y,” where “X” stands for the training and capacities of the therapist to provide an intervention and “Y” is the need of the client or patient and what they respond to well (Frankl, 2014:128). Clearly, he was talking about highly skilled and competent therapists who live in the world, and who can apply his open system of psychotherapy to individualize meaning-oriented treatment.
The first practitioners of logotherapy were trained by Frankl in Vienna and the USA (Fabry & Lukas, 1995). Some of them established training institutes which carried out training of generations of logotherapists (i.e. Batthyány & Lukas, 2020).
According to Teria Shantall, a former student of Dr. Frankl in the USA, “…his lectures were like no other lecture we have heard before, and we listened to him like we never listened before.” (Shantall, 2025).
Dr. Lukas related that the first occasion when she saw Dr. Frankl in action at the Polyclinic Hospital was quite a startling experience, and probably that is why she recalls it so clearly to this day:
A lady with a diagnosis of generalized anxiety was visited by Dr. Frankl and some of the interns during the rounds. Dr. Lukas, who met Dr. Frankl a short while ago after one of his lectures at the University of Vienna, was among them. To Dr. Frankl’s question, “How are you today?” the lady started to explain in detail her problem with anxiety which she related back to her youth when she rejected invitations out of fear and later blamed herself and judged herself harshly. She proceeded to give some examples of her the situations in which she felt anxiety, many years ago.
Dr. Frankl briskly interrupted her account by saying, “Dear Lady, how come now you are not ashamed of telling these stories in front of these young people and blaming yourself? Young people are so quick to laugh at such comical levels of scrupulosity! Or are you at least not scared of boring me, the respectful, gray-haired professor, with such trivialities?”
A silent hush fell over the ward. The students were standing there in stunned silence. They felt that Dr. Frankl had been cruel with his inquiry and had gone too far and offended her with his brisk inquiry. But, after some silence, the lady quipped: “Well, I figured if I want to become better, I have to express myself.” To which Dr. Frankl, with eyes sparkling, turned to the residents and exclaimed, “Did you hear that? Did you hear what she just said?” He asked the lady to repeat what she said, and this time, she said it even more loudly and confidently: “I figured that if I want to do better, I need to start speaking up about what is on my mind.” Dr. Frankl, beaming, asked her, in a soft tone, and with glistening eyes: “So…when you want something, when you really intend something, then you must overcome the anxiety…is that so?” “Do you really have to? Did the students force you to? Did I force you to stand up to the anxiety?” pursued Dr. Frankl. “No. no, no,” replied the lady somewhat surprised, “I just simply did it.” Still beaming, Frankl reiterated: “So when you want something, and you really want something very much, you just simply do it…did I hear you right? Then you jump over the anxiety? Bravo! I want to congratulate you for that!” he exclaimed, while the lady looked on as if awakened from her dreams.
“And with that,” continued Frankl, “now we are going to explore together what in your future is worthwhile and what is it that you really, really want. And for what reason you really want to recover.” (Lukas, 2012:32-33).
The conversation then continued in an ordinary tone and Dr. Lukas did not recall any further details. However, she remarked that Dr. Frank “broke all the rules” in the textbook (Lukas, 2012:33). His therapeutic skills were unmatched and unparallelled. This conversation turned out well in this situation with this patient and this therapist; however, this does not mean that one should aim for a therapeutic bravado. In fact. Dr. Frankl himself has remarked that the more doctors aim at performing their duties, the more they can heal. The aim should not be success or fame of the therapist but advancing the best interest of the patient.
With this objective in mind, as early as 1979, Dr. Elisabeth Lukas, addressed desirable professional competencies (Lukas, 1979-2019). She paid attention to the rationale, scope, ethical responsibilities and training methods, and standards for logotherapists (Lukas & Fabry, 1995). Soon, other therapists followed suit (i.e., Goodenough, 1996; Lantz, 1996; Estes, 1997; Graber, 2000; Estes, 2001; Sjölie, 2001; Graber, 2001; Finck, 20002; Esping, 2009; Wimberly, 2014). These developments dovetailed research that validated the effectiveness of logotherapy in addressing existential concerns and efforts to make logotherapy an integral part of clinical training in state-of-the-art health facilities (i.e., Bretibart and Poppito, 2014, Breitbart and Poppito, 2014b; Breitbart, 2017).
Currently, the Viktor Frankl Institute of Vienna lists accredited training institutes for logotherapy around the world (VFI, 2025). These training institutions are members of the International Association of Logotherapy and Existential Analysis through the Viktor Frankl Institute, Vienna. Training in these institutes follows the legal and ethical guidelines specified by respective regulatory bodies and the APA ethical guidelines (VFI, 2025). Professional exchanges during international conferences, peer-reviewed articles, peer groups and discussion groups, as well as consultation among professionals allow to stay abreast of research on logotherapy in various clinical settings, interdisciplinary applications, and trans-national significance (i.e., McLafferty and Levinson, 2024; Batthyány & Lukas, 2020; Batthyány, 2016; Lukas & Schönfeld, 2019; 2024).
Supervision and Consultation:
Experts in the field of psychotherapy supervision claim that “…supervision is one of the more common activities of mental health professionals” (Bernard and Goodyear, 2019:2). They cite the findings of a large-scale study with over two thousand participating therapists from over a dozen countries according to which “…the number of therapists who supervised increased from less than 1% for those in the first six months of practice, to between 85 to 90 % for those who have more than 15 years of practice” (Rønnestad, Orlinsky, Parks, and Davis, 1997; cited by Bernard and Goodyear, 2019:2).
Findings such as these highlight the importance of addressing supervision in meaning-centered psychotherapy. The premise of supervision, according to which (1) “clinical supervision is an intervention in its own right;” (2) “mental health professions are more alike than different in their practice of supervision,” and (3) “clinical supervision is effective in developing supervisee competence” (Bernard and Goodyear, 2019:2), makes a strong case for the need to describe supervision from the framework of Viktor E. Frankl’s LTEA in current clinical practice.
Definition of Terms:
Supervision is defined as the didactic pedagogical method and education that prepares therapists for competent practice:
“…a structured process where a more experienced professional (supervisor) guides and supports a less experienced professional (supervisee) in their therapeutic work. It’s a formal relationship that helps supervisees develop their skills, knowledge and competence, and ensures the quality of services provided to clients This process involves reflection, learning, and evaluation of the supervisee’s work.” (CCPA, 2025)
Consultation in a professional setting refers to “…obtaining advice regarding the way forward with a particular client, clinical issues, or issues related to professional practice. Clinical consultation is an activity that ensures that standards of care are met.” (Tisdall & Greben, 1992). It is appropriate and necessary “…When registrants are treating a client within their practice area and encounter an issue beyond their competence, registrants receive clinical supervision or consult a more experienced colleague.” (CRPO, 2025).
The similarity between supervision and consultation is that both belong to standards of practice regulated and advised by licensing bodies and governed by ethical standards in order to ensure best practices. The difference between supervision and consultation is that supervision requires a formal arrangement between a more senior and experienced therapist and a less experienced therapist, which is specified in writing through a formal contract outlining the roles, and responsibilities of each, it also has an evaluative component, because it is undertaken for the purpose of fulfilling legal and ethical obligations to gain proficiency in a field of practice or a modality.
Consultation entails a less formal arrangement between an “expert,” a more experienced or senior therapist, a consultant, or a peer, a fellow clinician with experience. The purpose of consultation is time and person specific since it helps to gain information or feedback regarding a specific issue or situation and there is no formal requirement for regular meetings, such as once a week, or at least once per every five to eight, or at least ten client hours, as is the ethical requirement for supervision. (CRPO, 2025)
Consultation, like supervision, requires consent from patients when identifying information is shared, and is undertaken voluntarily by therapists to further their knowledge and efficiency. When consultation is requested about a specific patient, the outcome of the meeting is documented in the file. General consultations, such as information that is shared anonymously in peer meetings, are not required to be documented in client files. However, they may be required to be recorded as part of the therapist’s professional development activities. (CRPO, 2025)
The Process of LTEA Supervision:
The process of supervision has four stages: preparation, goal setting, delivery, closure, and transition. This model is usually followed by large institutions and training centers. There are some principles that are shared by all modalities that apply to supervision, and there are some that are specific to LTEA.
1. Preparation
In order to supervise others, supervisors must possess good therapeutic skills and competencies (APA, 2025; CRPO, 2025). They must be comfortable and willing to share their knowledge with others, the basis of which is their own self-awareness. They need to have insight into their strengths and limitations and to be able to model being reflective practitioners (Shepard, et al., 2016).
Usually, four to five years of practice with clients is required before one can be in the position of supervisor, however, this can vary with the number of client hours they have, and their level of comfort. (Shepard, et al., 2016) Supervisors must reflect on their background, training, experience, feelings, attitudes, and beliefs about the people they are interacting with. They need to be aware of their potential preconceptions, biases, judgements, and the model of training that they have received, as well as the models they use and are comfortable with. They must understand also the power imbalance that exists between client and therapist, and supervisor and supervisee, and manage this power difference for the benefit of clients and supervisees (CRPO, 2025).
After supervisors reflect on their abilities and their capacities to provide supervision, they need to determine if there is a good match or fit with their supervisees (Shepard, et al., 2016). Supervisors may be at different levels of professional expertise, and initially, may not have much understanding of the theoretical framework of the supervisor. Thus, it is important for the supervisor to be able to clearly and concisely communicate the framework that they will use in their supervision to make sure that there is an alignment with the values and beliefs of supervisees, otherwise, supervision will not be effective (Shepard et al., 2016).
A beginning statement of the logotherapeutic framework may be as follows:
Logotherapy and Existential Analysis is a meaning-centered approach to psychotherapy. It was founded by Dr. Viktor Frankl (1905-1997), who was a medical doctor, neurologist and psychiatrist, professor of psychiatry at the University of Vienna, and a holocaust survivor. He is most well known for being the author of the book, “Man’s Search for Meaning.” Many libraries of the world carry this book. In it, Frankl presents the fundamental belief that life offers us meaning under any circumstance. Meaning is life is not a new concept, because since the dawn of humanity people possessed a will to meaning. However, Frankl was the first to propose that the motivation to find meaning is fundamental to human beings, and it is more important than the will to pleasure or the will to power. Frankl demonstrated that helping people live with meaning has preventive and curative properties. In this book, he laid out some of the principles of his approach to psychotherapy, which he called logotherapy and existential analysis. Logotherapy is an evidence-based method among the humanistic and existentialist approaches to psychotherapy. It can be efficient wherever concerns or symptoms are coupled with existential issues since it has been specifically developed to address the feeling of meaninglessness.
Additionally, supervisors need to determine the styles of learning that they can provide either through in-vivo modeling, co-counseling, or case reviews in dyadic meetings or group meetings (Shepard, et al., 2016). Initially, supervisees may be more comfortable with observation, and some may require repeated attempts and modeling before they become comfortable with the use of a method. Supervisors need to know in advance which methods they are most comfortable or uncomfortable with. This information needs to be given to supervisees in advance to help them make a decision about whether the supervisor will be suitable for their style of learning.
Supervisors also need to gather information from their supervisees about their expectations, experience, preparation, and other evaluations in order to determine if they feel comfortable providing the level of supervision required by the supervisee (Shepard., et al., 2016). Supervisees can be (1) at the novice level (beginner); (2) intermediate (competent); and (3) advanced level (experienced; Shephard, 2016).
The criteria for deciding whether the supervisee and the supervisor are going to be a good match is their ability to collaborate well, feel understood, supported, and when the supervision experience is positive and nurtures professional growth. An evaluation of whether the supervisor and the supervisee are potentially a good match can take place during face-to-face interactions, in writing, or through feedback about the supervisee’s performance.
Working together as a team begins when the supervisor and the supervisee agree on shared goals in supervision.
Supervisors may agree to provide foundational skills (usually during the first placement when basic skills are developed), applied experience (usually during a degree program or residency training) or support the expansion of competencies (usually post-degree supervised application of methods; Shepard et al., 2016:20). Not necessarily everyone follows the same trajectory, therefore, both need to understand the scope of supervision provided, how it will be provided, and, like a roadmap, what the objectives will be.
The agreement from here on will specify that the supervisor will bear responsibility for the safety of the supervisee’s clients, and the supervisee’s responsibilities about promptly informing and being in touch with the supervisor on a regular basis are established. (CRPO, 2025). The contract will outline the number of client hours for which supervision will be provided. It will also highlight the targeted client characteristics, the intervention formats, the training format and the proximity and availability of the supervisor. It will also highlight the boundaries of the supervision, such as what it will not cover, such as supervisor competence, client availability, certain types of clienteles, or certain types of work environments.
The process of supervision becomes like a journey, where supervisor and supervisors agree on how far the supervisor can accompany the student where the student is headed, and “…how far they can travel together” (Shepard, et al., 2016:16). Alternative arrangements can be considered in advance related to illness or change of personal circumstances. Finally, an informed consent should be gained about the risks of supervision, its anticipated benefits and how disputes will be handled. (CRPO, 2025)
2. Goal Setting:
Initial logotherapy practice and supervision: The goals of the supervision may be to familiarize the supervisee with the basic concepts of logotherapy. These include logotherapy as an open system of psychotherapy, the anthropological bases, the philosophical bases, and the psychotherapeutic bases of logotherapy, underlying an understanding of the human being as anthropological totality, the dimensions of human existence, logotherapy’ theory of motivation, the concept of “freedom of will” and “will meaning,” and Frankl’s concept of “one humanity and individual uniqueness” can be explained.
Basic skills include active listening, the use of key words, Socratic questioning, the use of stories and metaphors. The psycho-physical parallel and psycho-noetic antagonism can be followed by understanding the anthropological foundations of fate and freedom. The basics of existential analysis can be introduced, followed by a holistic view of the person and diagnostic considerations. Existential dynamics can be explained. Discuss situations when logotherapy is specifically applied, such as for concerns that have existential correlates and where the question of meaning surfaces. The basics of existential conceptualization and case formulation can be introduced. The tragic triad of pain, guilt and death can be explained and Frankl’s case for a tragic optimism can be presented. Research articles, books and related audio and video taped material can be presented, depending on supervises’ interest. Some material here is mandatory, such as familiarity with protocols, basic principes, ethical guidelines.
At this stage direct instruction needs to be given regarding obtaining informed consent, confidentiality, exceptions to confidentiality, modeling and practicing active listening, questioning skills, and summarizing skills, suicide prevention protocol, collaboration with professionals, and areas of specialty where referral is required to a more seasoned therapist.
Ongoing Clinical Practice: Advanced case conceptualization skills can be presented, with emphasis on existential correlations, diagnostic considerations, comorbidity, predisposing, precipitating, perpetuating, and protective factors. Frankl’s system of diagnosis can be introduced with presenting life positions such as provisory attitude, fatalism, fanaticism, collectivistic thinking, and individual patterns such as excessive forcing and fighting for, excessive self-observation, and excessive avoidance that contribute to the symptoms.
Logotherapy’s methods such as paradoxical intention, and de-reflection can be introduced. Modification of attitudes with the Socratic method can be deepened. Other methods of logotherapy, structured, semi-structured, and unstructured interventions with groups, families, couples and individuals can be presented. The needs of specific client populations can be discussed, and interdisciplinary work can be illustrated. Didactic teaching methods can review the basics and build further competencies, supported by research and literature.
Supervisees at this stage may take more initiative and explore areas of interest. Instruction focuses on teaching methods and modeling their applications with individuals, couples, or groups. Supervisees may take the initiative to engage in ongoing learning, writing, presenting their work and collaborating with other professionals.
Experienced Therapist: This supervisor can provide guidance with respect to complex cases and conceptualization. Familiarity with existential dynamics, holistic case conceptualization and focus on the implementation of a logotherapeutic treatment plan can be enhanced. Discussion of the therapeutic process, reflection on therapeutic errors can be facilitated. Deepening understanding of factors that contribute to wellness and the role of protective factors can be taught. Ongoing learning, refining skills, and applications in complex situations can be arranged. Understanding what it means to optimize and look for the best possible option for all involved can be illustrated. Deepening self-understanding, self-reflection skills can be enhanced. The concepts of vicarious trauma and moral injury that can occur during therapy can be elucidated. Trauma informed care, and integration of various modalities into meaning-centered care can be introduced. Designing tailored plans and individualizing treatment approaches can be practiced. At this stage, supervisees are usually comfortable with creative improvisation and individualization enhanced by awareness of limitations, indications, and contra-indications of treatment interventions. They are competent in various modalities, trans-cultural applications, and interdisciplinary collaboration.
The supervisory role shifts to guidance, suggestion, and exploration. Supervisees can apply some principles in their own lives and design programs that reach beyond their workplace to the community.
3. Delivery of Supervision:
According to Shephard and her colleagues, the supervisees are not their equals, and “…can never become their equals or their colleagues” because the power differential remains as long as supervision takes place (Shepard, et al., 2026:18). Transference and countertransference are recognized issues in the framework of many modalities (Shephard, et al., 2016:18). One needs to develop an awareness of them.
In the logotherapeutic framework how transference and countertransference are dealt with beyond the awareness of feelings and emotions is by transcending toward the meaning of the moment: the best interest of the client. Supervisors need to manage the power difference so as to facilitate the supervisee instead of impeding them. Supervisors need to be authentic and be aware of their reactions. If required, they could draw attention to awareness of feelings and thoughts on part of the supervisees. Both then look toward their area of freedom, which is the attitude they can take toward their thoughts and feelings, and the options they gave in this area, some of which are more meaningful than the others. They could then decide what response makes the most sense, and if it is different from the initial reaction, modify their response in the present to reflect their values.
In supervision, we can differentiate between what a person does, and who a person is. A person’s worth is unconditional, but some thoughts and feelings are not worth putting into action. An example of how supervision and interventions can be similar, we can affirm that a person is not responsible for their thoughts or emotions, but they are responsible for their actions. Professional responsibility and ethical guidelines hold supervisors and supervisee responsible for identifying any impediments that can hinder the supervision process or impede the capacity to deliver competent service to clients (CRPO, 2025)
Since the supervisor cannot always directly engage with challenging clients, there is always a tendency to think first: What would I have done in this situation? And then to instruct supervisees. The beginner supervisor may have a tendency to do this more often. With experience, supervisors gain confidence to question their supervisees and guide them to discover some answers for themselves. This can be helpful when the situation is not an emergency situation, and there is space to deliberate options (Shepard, et al., 2016).
A related issue has to do with providing constructive or destructive feedback. Logotherapeutic counselors do not aim to “unmask” or “debunk” certain truths about their supervisees. Even if there is a gap in their knowledge, the reasonable answer is to notice it, bring it to the supervisee’s awareness and address it with them, rather than give disparaging feedback that makes them fear the supervisor but not necessarily make them more motivated to learn new skills.
Consider the self-report by one of Dr. Frankl’s international students in Vienna. He was afraid of voicing his opinion to his supervisors and as a result increasingly felt ineffective as a therapist. He had an inner sense of emptiness and void inside. He started to undertake psychoanalysis in which his problems were explained in terms of early childhood experiences. This made him doubt his effectiveness as a therapist, nearly to the point of paralysis. Only when he heard Frankl say that certain existential concerns can be a sign of authentic humanity and not pathological symptoms, he experienced a turnaround. He stopped his therapy and started to be more assertive with his supervisor. This gave him a renewed sense of meaning and purpose, which improved his overall wellbeing. (Frankl, 1979:38-40)
Just like in therapy, hyper reflection can be an issue in supervision. Hyper-reflection occurs when people excessively observe themselves and want to demand results from themselves. (Frankl, 2014) This can be exacerbated by programs they watch where therapists are portrayed with superpowers, or case studies offered to them in which there was a dramatic change. There are such examples in textbooks because they are intended to capture the most outstanding part of a conversation. Supervisees are then trapped in the attempt to replicate these results, but with no success. The risk is that their hyper-observation of themselves and their performance takes away from their spontaneity.
While supervision is not a therapy session, a supportive supervisor can discuss these dynamics, and the supportive atmosphere can dispel unreasonable myths. This can aid therapists to have reasonable expectations about themselves and their skills, which in no small measure is related to the relationship they can establish with their client. A trusting relationship cannot be too well established if the therapist’s self-observation is focused on themselves. Thus, supervisors can help them to learn how to be fully with their client and intend to “forget themselves” in other words, to become instruments of healing. In the LTEA framework, healing will come from clients’ insights and strength, and for that therapists need to be ready to be well-trained and prepared guides.
Iatrogenic damage occurs in therapy when clients experience additional suffering because of something that the therapist has said or failed to say. “Iatros” is derived from the Greek word for the “healer.” The suffix “ic” means “from the doctor.” Thus, iatrogenic damage is “…harm brought forth by the healer or any unintended adverse patient outcome because of a health care intervention, not considered natural course of the illness or injury.” (HIGN, 2025). Such damage can be caused also in supervision. This is the effect of supervisors mismanaging the power imbalance and inadvertently verbally or non-verbally give a message to their supervisee that is inconsistent with the goals of supervision. For example, they may push their supervisee too far, beyond their comfort of disclosing information, interrupt and make conclusions without waiting for their supervisees to voice their conclusions; be quick with diagnoses or labels that are unhelpful to develop an existential formulation; imply that clients are hopeless, or beyond help. Each time when reductionistic assumptions are made that belittle the client’s abilities and the supervisee’s capacities because the teaching style is overly controlling, or punitive, silent, or too lenient, which is unhelpful when someone needs guidance, there is a danger for iatrogenic damage in the supervision setting.
Dr. Lukas described how iatrogenic damage can be inadvertently caused in therapy: (1) Showing more interest in problem areas than skills and resources; (2) taking blows of fate as tragedies; (3) giving negative prognosis on the basis of some research findings that are not helpful; (4) assigning diagnoses without explaining what they mean and talking in clinical jargon that clients do not follow; (5) silence at the wrong times; and (6) unreasonable hypotheses (Lukas, 2013:19).
The competent logotherapist knows when to “explore cause and ignore causes” (Lukas, 2019:141). For example, in the case of a reactive depression that followed the death of a loved one, the therapist will take loss and grief into consideration. Advising a mother to spend time with their child and read to them, despite the child’s learning challenges will be an example where the fulfillment of a negative prognosis can be ameliorated. Here what guides the therapist is that often the stand that they take toward what can be established with a diagnosis can make a difference in the manifestations of a condition or influence the path to recovery.
The wise logotherapist emphasizes responsibility where it is due but not where it is not due (Lukas, 2019). In supervision, for example, the senior therapist takes responsibility for ensuring that patients receive the quality of care that patients are expected to receive. They assign less-demanding roles to less experienced therapists so they can gradually learn to perform their duties with gradual exposure to people who have more complex needs.
Logotherapy is a value-based approach, so in this context it is highly relevant that therapists understand their guiding principles. In the course of their work, they come in contact with people from who may hold different world views than their own. This can happen when they work with individuals from different cultures, but is not limited to it, as there is a large variety of experiences and ways in which people live. One of the assumptions of Logotherapy is that people have “free will,” and “the will to meaning” to discover the meaning that life offers. In the search for what is worthwhile, the values that are worth actualizing, conscience is an important guide because it helps to point out objective meaning, which is always person and situation specific (Frankl, 2014).
In meaning-centered therapy, the Socratic method is often employed to gain perspectives and to discern what meaning is awaiting the patient. Meaning, in general is what corresponds to the truth, beauty, goodness, and which is in harmony with universal human values, such as dignity of the person and value of human life (Marshall & Marshall, 2023). Instances where there are blatant violations against human rights and values have to be addressed can present real challenges to therapists. In such cases they benefit from support from peers and the experience of senior members.
In Dr. Frankl’s biography, we encounter instances when he was personally or professionally attacked because of his life affirming stand. On one occasion for example, when he was ready to move to Australia, he received a note of encouragement from the Lubavitcher Rebbe (Klingberg, 2001). Complex ethical dilemmas are instances where one must decide in consultation with professionals from various disciplines. Oftentimes, the best possible solution is the one that is optimal: it is the best possible solution for all the parties involved.
The process of supervision should focus on exploring and expanding the knowledge that supervisees already possess to gradually build on the experience they have. The process is like scaffolding, a term borrowed from developmental psychology, where more complex skills can be built after the mastery of the basics. The work of the supervisor and the supervisee ought to take into consideration the setting, the types of clients, the learning model and the theoretical framework within which supervision is provided, and support self-awareness and self-reflection as part of continuous learning (Shepard, et al., 2016). Knowledge, skills, and attitudes will be imparted and discussed, and gradually professional judgment develops in consultation and collaboration as supervisees gain more confidence. Consolidating the acquired new knowledge can occur through continued practice, discussions, attending enrichment activities and retreats.
Dr. Frankl referred to the training of a good therapist as similar to a mountain guide (Frankl, 2010). A good guide must be familiar with the terrain, know the hidden paths and dangers, the shortcuts, the times and seasons, and the signs of times to safely navigate mountainous terrains and help others reach their destination. Similarly, said Frankl, a good therapist must be ready to be confronted with life’s challenges in order to offer experts advice and help when needed.
4. Closure and Transition:
Literature in supervisor training ends with disengagement, transition and closure (Shapard, et al., 2016). As the formal contract between supervisor and supervisee ends, it is assumed that the objectives have been reached, and the supervisee is in a better position to continue in independent practice. At this time, supervisors can accord supervisees greater responsibilities, gradually transfer roles, tasks and responsibilities. This time is a transition point for supervisees as they will now be in the position to teach others, research, and present their work. Supervisors review with their supervisees the progress that has been made, the goals that have been set and the targets which have been reached. There may be some uncertainty around this time if supervisors are gatekeepers and they need to officially share their findings with licensing bodies (Shapard, et al., 2016). The steps of these evaluations and their content are usually shared with supervisees who move on to independent work. Supervisors may also experience some excitement about letting go and from a distance observing, encouraging and standing by their former supervisees, who are now ready to fully assume their professional responsibilities. They are familiar with and abide with ethical principles and able to use their skills with patients in an effective and safe manner.
In line with APA ethical standards, therapists who are members of the International Association of LTEA pledge to continue to engage in ongoing professional development and formation to keep current through reading literature and formal and informal consultations with peers and colleagues in their field about emerging issues and trends (APA, 2025).
Concluding Remarks:
Following the regulation of psychotherapy in different jurisdictions, the practice of supervision and consultation in psychotherapy has become more structured.
It is possible to integrate the classical principles, practice, and methods of logotherapy and existential analysis into the regulatory framework of supervision and consultation in psychotherapy within each jurisdiction.
The world has changed since Frankl worked at the Polyclinic Hospital. However, some issues have remained the same, and many have become even more burning than before. First and foremost, people are searching for meaning. However, as Frankl observed this a long time ago, rather than wanting to be happy, they long to find a reason to be happy.
Supervision and consultation in Logotherapy can ensure that the future will not lack professionals who are willing to dedicate themselves to the care and consolation of the sick and suffering and who can competently accompany them to discover meaning.
References:
APA (2025). Ethical principles of psychologists and code of conduct. American Psychological Association. Retrieved from: www.apa.org. Accessed: June 15, 2025.
Batthyány, A. (2016). Logotherapy and Existential Analysis: Proceedings of the Viktor Frankl Institute Vienna, Volume 1. Springer.
Batthyány, A. & Lukas, E. (2020). Logotherapie und Existenzanalyse Heute: Eine Standortsbestimmung. [Logotherapy and Existential Analysis Today: A Standpoint]. Innsbruck/Vienna: Tyrolia.
Breitbart, W. S. (2017). Meaning-centered psychotherapy in the cancer setting. New Tork, NY: Oxford University Press.
Breitbart, W. S., and Poppito, S. (2014a). Individual meaning-centered psychotherapy for patients with advanced cancer. A Treatment Manual. New York, NY: Oxford University Press.
Breitbart, W. S. and Poppito, S. (2014b). Meaning-centered group psychotherapy for patients with advanced cancer. A treatment manual. New York, NY: Oxford University Press.
CCPA (2025). Supervision for Psychotherapists definition. Canadian Counselling and Psychotherapy Association. Retrieved from: www.ccpa-accp.ca Accessed: June 15, 2025.
CRPO (2025). Standards 2.1: Seeking Consultation, Clinical Supervision, & Referral. College of Registered Psychotherapists of Ontario. Retrieved from: www.crpo.ca/practice-standards/competence/seeking-consultation-clinical-supervision-referral/ Accessed: June 15, 2025.
Esping, A. (2009). Frankl’s ‘platform’ as a metaphor foe unusually personal dissertation projects. The IFL, 32(1), 37-43.
Estes, K. (1997). Logotherapy in Counselor Education: Important but Neglected. The International Forum for Logotherapy, 20(1), 20-27.
Estes, K. (2000). A Report of the Education and Credentialing Committee. The International Forum for Logotherapy, 24(2), 115-116.
Fabry, J. & Lukas, E. (1995). Auf den Spuren des Logos. Briefwechsel mit Viktor E. Frankl. Berlin-Münich: Quintessenz.
Finck, W. C. (2002). Three-dimensional Education: Re-humanizing America’s Educational System. The IFL, 25(2), 96-101.
Frankl, V. E. (1979). A Case of Noogenic Neurosis. Case Histories. The International Forum for Logotherapy. Volume 2(2), 38-40.
Frankl, V. E. (2000). Recollections. An Autobiography. Cambridge, MA: Perseus.
Frankl, V. E. (2008). Bergerlebniss und Sinnerfahrung. Innsbruck, Austria: Tyrolia.
Frankl, V. E. (2014). The Will to Meaning. Foundations and Applications of Logotherapy. Expanded edition. New York, NY: Plume.
Frankl, V. E. (2014b). Man’s Search for Meaning. Boston, MA: Beacon Press.
Goodenough, R. W. (1996). Legal Responsibility of Logotherapists. The International Forum for Logotherapy, 19(2), 65-72.
Graber, A. (2000). Viktor Frankl Institute of Logotherapy Offers Foundation Courses in Logotherapy via Distance Learning. The International Forum for Logotherapy, 23(1), 40-46.
Graber, A. (2001). Partnering Resources in Education: Viktor Frankl Institute and Graduate Theological Foundation. The IFL, 24(2), 124-125.
HIGN (2025). Iatrogenesis. Hartford Institute for Geriatric Nursing. Retrieved from: https://hign.org. Accessed: June 15, 2025.
Klingberg, H. (2001). When life calls out to us. The love and life of Viktor and Elly Frankl. New York, London, Toronto: Doubleday.
Lantz, J. (1996). Logotherapy Training: The Worthington Model. The International Forum for Logotherapy, 19(2), 100-103.
Lukas, E. (2012). Vom Sinn Getragen. Ein Leben fur die Logotherapie. Münich, Germany: Kösel.
Lukas, E. (2013). Ausbildung in der originaren Logotherapie nach Viktor Frankl. Semesetr IV. Logotherapie in der Krisenintervention 2. Die iatrogene Neurose. Bamberg, Germany: Elisabeth Lukas Archives.
Lukas, E. (1979-2019). The Ideal Logotherapist: Three Contradictions. Meaningful Living. C. McLafferty (Ed.) Charlottesville, VA: Purpose Research.
Lukas, E. (2000). Logotherapy Textbook. Tontonto, Ontario: University of Toronto Press.
Lukas, E. & Farbry, J. (1995). Auf den Spuren des Logos. Briefwechsel mit Viktor Frankl. Quintessenz.
Lukas, E. & Schönfeld, H. (2019). Meaning-centered Psychotherapy. Bamberg, Germany: Elisabeth Lukas Archives.
Lukas, E. & Schönfeld, H. (2024). Meaningful Renunciation. Rethinking Crisis Management. Bamberg, Germany: Elisabeth Lukas Archives.
McLafferty, C. & Levinson, J. (2024). A. Batthyány (Series Editor). Logotherapy and Existential Analysis. Proceedings of the Viktor Frankl Institute. Volume 2. Springer.
Marshall, M. & Marshall, E. (2023). Viktor E. Frankl’s Logotherapy and Existential Analysis: Theory and Practice. Ottawa, Ontario: Ottawa Institute of Logotherapy.
Tisdall, G. W. & Greben, S. E. (1992). Consultation in Psychotherapy. National Library of Medicine. Doi: 10.1176/appi.psychotheraoy.1992.46.2.262 Retrieved from: pubmed.ncbi.nlm.nih.gov/1605333/ Accessed: June 15, 2025.
Shantall, T. (2025). Farewell to Dr. Shantall and handover to Mark Graham Wilson. Youtube Recording. 17 September 2025. Retrieved from: https://www.youtube.com/watch?v=33Un4HGnmQY. Accessed: September 23, 2025.
Sjölie, I. (2001). An example of teaching logotherapy outside the USA following the guidelines of the Viktor Frankl Institute of Logotherapy. The IFL, 24(2), 112-114.
Wimberly, C. (2014). The Viktor Frankl Institute of Logotherapy Diplomate Credential. The IFL, 37(1), 44-46.
Maria Marshall, PhD, RP is Mignon G. Eisenberg Professor of Logotherapy at the Graduate Theological Foundation. She is Diplomate Clinician in Logotherapy. Registered Psychotherapist and co-founder of the Ottawa Institute of Logotherapy.
Edward Marshall, MD, PhD, RP, is the Viktor E. Frankl Professor of Spirituality at the Graduate Theological Foundation. He is Diplomate Clinician in Logotherapy. Registered Psychotherapist and co-founder of the Ottawa Institute of Logotherapy.